UK Sees Significant Increase In Organ Donation Due To NICE Guidance

In short

The UK’s TV and radio media are today full of the news that the number of people donating organs after death has risen by 50 per cent in the last five years. Advisory body the National Institute for Health and Clinical Excellence (NICE) is claiming some of the credit for this success following its own initiatives to recruit more potential donors.

Background

More than 1,200 people in the UK donated their organs in the last year, leading to about 3,100 transplants, according to NHS Blood and Transplant (NHSBT) who compiled the figures.

NICE’s guidance has helped to identify a greater number of patients who may become suitable donors. Published in December 2011, these guidelines on organ donation recommend that patients who are potentially suitable donors should be identified as early as possible based on two possible criteria.

The first is defined clinical trigger factors, which indicate a high likelihood of brainstem death, in patients who have had a catastrophic brain injury. The second is the intention to withdraw life-sustaining treatment in patients with a life-threatening or limiting condition which will, or is expected to, result in circulatory death.

If the patient is in circumstances where they are able to make their own decisions, the healthcare team should seek their views on organ donation and consent, says NICE.

If the patient is close to death and unable to make their own decisions on consent, the healthcare team should determine whether taking steps before death to help organ donation would be in the patient’s best interests.

This can be done by considering the patient’s known wishes and feelings, asking people close to the patient what their thoughts and wishes are, checking whether the patient is on the organ register, and whether they left an advance statement.

The guideline recommends that those close to the patient should be approached in a setting suitable for private and compassionate discussion, and they should be given sufficient time to consider the information.

NICE comments

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE said: “The NICE guideline has been the trigger for the increase in organ donations seen since 2011.

“Organ donation can be a sensitive subject, particularly if decisions are made at a time of bereavement. It’s important that healthcare professionals have clear guideline in place to support and assist them.”

“Whilst there is clearly more to do in improving consent rates for organ donation, exceptional progress has been achieved in the other main focus of the NICE clinical guideline in identifying patients who might become suitable donors and this is where much of the increase in donation has come from.”

Sally Johnson, NHS Blood and Transplant’s Director of Organ Donation and Transplantation, said: “Although I am delighted that we have made such big advances in the UK, we can and must do more.

“We need a transformation in donor and family consent to organ donation because the UK’s family refusal rate remains one of the highest in Europe. Without that, there is only a limited amount more the NHS can do to offer further hope to those on the waiting list for an organ transplant.”

A new strategy is expected this summer which will build on the recommendations of the original Organ Donor Taskforce and set new challenges to help the three people a day who are still dying due to lack of suitable available organs.